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Background <p>Idiopathic intracranial hypertension (IIH) is marked by elevated intracranial pressure with risk of vision loss. Neurofilament light chain (NfL), a marker of axonal injury, may reflect optic nerve damage in IIH.</p> Objective <p>To assess the relationship between cerebrospinal fluid (CSF) and serum NfL levels, papilledema severity, and radiological findings in patients with IIH.</p> Methods <p>A cross-sectional study was performed on 34 women with IIH and 34 age- and sex-matched healthy controls. Demographics, clinical features, ophthalmological evaluation, lumbar puncture opening pressure measurement, brain MRI/MRV, and ONSD ultrasound were performed. NfL levels were measured in CSF and serum using ELISA. Correlations with papilledema grade (Frisén scale) and radiological findings were analyzed.</p> Results <p>IIH patients had higher BMI (34.2 vs. 27.3&#xa0;kg/m², <i>p</i> &lt; 0.001) and ONSD (6.39 vs. 5.40&#xa0;mm, <i>p</i> &lt; 0.001). CSF NfL levels were elevated (median 79.8 ng/L) and positively correlated with papilledema grade (<i>r</i> = 0.383, <i>p</i> = 0.031) but negatively with ONSD (<i>r</i> = -0.352, <i>p</i> = 0.041). ONSD correlated strongly with papilledema (<i>r</i> = 0.456, <i>p</i> = 0.009) and lumbar puncture pressure (<i>r</i> = 0.502, <i>p</i> = 0.002). Serum NfL showed no significant difference between patients and controls (<i>p</i> = 0.562) and no correlation with disease severity.</p> Conclusion <p>CSF NfL correlates with papilledema grade and may serve as an objective biomarker of optic nerve damage in IIH. Its complementary role alongside ONSD suggests potential for a dual biomarker approach, combining acute pressure assessment with cumulative axonal injury monitoring.</p>

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Neurofilament light chain levels as a biomarker in idiopathic intracranial hypertension: correlations with papilledema and radiological findings

  • 期刊论文

  • 发表日期：

    2025年11月20日

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  • Ahmed Hamdy,
  • Shimaa Elgamal,
  • Reem Algamal,
  • Hadeer Elsaeed AboElfarh,
  • Muhammad Abdelshafi Elsayed,
  • Ahmed Reda Abdelmeguid Moustafa,
  • Yasmeena Abdelall Kozaa,
  • Hossam Egila,
  • Osama Elshafei

摘要

Background

Idiopathic intracranial hypertension (IIH) is marked by elevated intracranial pressure with risk of vision loss. Neurofilament light chain (NfL), a marker of axonal injury, may reflect optic nerve damage in IIH.

Objective

To assess the relationship between cerebrospinal fluid (CSF) and serum NfL levels, papilledema severity, and radiological findings in patients with IIH.

Methods

A cross-sectional study was performed on 34 women with IIH and 34 age- and sex-matched healthy controls. Demographics, clinical features, ophthalmological evaluation, lumbar puncture opening pressure measurement, brain MRI/MRV, and ONSD ultrasound were performed. NfL levels were measured in CSF and serum using ELISA. Correlations with papilledema grade (Frisén scale) and radiological findings were analyzed.

Results

IIH patients had higher BMI (34.2 vs. 27.3 kg/m², p < 0.001) and ONSD (6.39 vs. 5.40 mm, p < 0.001). CSF NfL levels were elevated (median 79.8 ng/L) and positively correlated with papilledema grade (r = 0.383, p = 0.031) but negatively with ONSD (r = -0.352, p = 0.041). ONSD correlated strongly with papilledema (r = 0.456, p = 0.009) and lumbar puncture pressure (r = 0.502, p = 0.002). Serum NfL showed no significant difference between patients and controls (p = 0.562) and no correlation with disease severity.

Conclusion

CSF NfL correlates with papilledema grade and may serve as an objective biomarker of optic nerve damage in IIH. Its complementary role alongside ONSD suggests potential for a dual biomarker approach, combining acute pressure assessment with cumulative axonal injury monitoring.